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    27 J U L I 2010 NO. Nama Obat ISI Dosis Sediaan Kemasan Farmasi Harga Analgesik

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    Idi JakSel Rsf
    The document appears to be a formulary or price list for medicines and medical supplies used at a type C & D public hospital in Tangsel, Indonesia. It includes the names, contents, dosages, forms, packaging, manufacturers and prices of various analgesics, anesthetics, antibiotics, anti-emetics, and other drug categories. It also lists prices for medical procedures, diagnostic tests, blood services, and materials used for curettage and caesarean section procedures.

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    27 J U L I 2010 NO. Nama Obat ISI Dosis Sediaan Kemasan Farmasi Harga Analgesik

    Uploaded by

    Idi JakSel Rsf
    135 views3 pages
    The document appears to be a formulary or price list for medicines and medical supplies used at a type C & D public hospital in Tangsel, Indonesia. It includes the names, contents, dosages, forms, packaging, manufacturers and prices of various analgesics, anesthetics, antibiotics, anti-emetics, and other drug categories. It also lists prices for medical procedures, diagnostic tests, blood services, and materials used for curettage and caesarean section procedures.

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    jamkesda1010

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    The document appears to be a formulary or price list for medicines and medical supplies used at a type C & D public hospital in Tangsel, Indonesia. It includes the names, contents, dosages, forms, packaging, manufacturers and prices of various analgesics, anesthetics, antibiotics, anti-emetics, and other drug categories. It also lists prices for medical procedures, diagnostic tests, blood services, and materials used for curettage and caesarean section procedures.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    135 views3 pages

    27 J U L I 2010 NO. Nama Obat ISI Dosis Sediaan Kemasan Farmasi Harga Analgesik

    Uploaded by

    Idi JakSel Rsf
    The document appears to be a formulary or price list for medicines and medical supplies used at a type C & D public hospital in Tangsel, Indonesia. It includes the names, contents, dosages, forms, packaging, manufacturers and prices of various analgesics, anesthetics, antibiotics, anti-emetics, and other drug categories. It also lists prices for medical procedures, diagnostic tests, blood services, and materials used for curettage and caesarean section procedures.

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    FORMULARIUM OBAT JAMKESDA TANGSEL TIPE C & D

    YG DIPAKAI OBGYN RSIA


    27 J U L I 2010
    NO. NAMA OBAT ISI DOSIS SEDIAAN KEMASAN FARMASI HARGA
    ANALGESIK
    1 KETOROLAC 10 ketorolac 10MG @ 1ML AMP BOX/6 dexa/hexpharm 74,250
    2 KETOROLAC 30 ketorolac 30MG @ 1ML AMP BOX/6 dexa/hexpharm 111,375
    3 As. Mefenamat 250 Asam mefenamat 250mg kapsul box/100 kimia farma 9,500
    4 As. Mefenamat 500 Asam mefenamat 500mg tablet box/100 kimia farma 13,500
    5 PARACETAMOL Paracetamol 500mg tablet box/100 kimia farma 8,800
    6 tramadol tramadol 50mg kapsul box/50 22,238

    ANASTESI LOKAL
    1 BUPIVAKAIN bupivakain 0,5% + dex 7,5% amp box/5 201,025
    2 LIDOKAIN LIDOKAIN
    ANASTESI UMUM
    1 KETAMIN ketamin 10mg/ml @20ml amp box/10 137,750
    2 MIDAZOLAM midazolam 5mg/5ml amp box/1 6,500
    3 MIDAZOLAM midazolam 15mg/3ml amp box/1 14,500
    4 PROPOFOL propofol 1%/20ml amp box/1 38,500
    5 OKSIGEN OKSIGEN TABUNG BESAR TABUNG TABUNG 38,500
    6 TIOPENTAL TIOPENTAL 1000MG/AMP @ 10ML AMP BOX/1 75,724

    ANTIBIOTIKA
    1 AMOKSISILIN amoksisilin trihidrat 500mg tablet box/100 indofarma 37,500
    2 KLINDAMISIN klindamisin 300mg kapsul box/100 indofarma 95,000
    3 Sefoktaksim sefoktasim 1 grm amp box/2 24,106
    4 Sefoktaksim sefoktasim 0,5grm amp box/2 12,054
    5 Seftazidim seftazidim 1 grm amp box/2 104,500
    6 Seftriakson seftriakson 1 grm amp box/2 26,525
    7 Gentamisin gentamisin 40mg/ml @ 2ml amp box/10 30,000

    ANTI EMETIK
    1 METOKLOPRAMID metoklopramid 10mg tablet box/100 kimia farma 9,200
    2 METOKLOPRAMID metoklopramid 5mg/ml amp box/10 kimia farma 11,500
    3 ONDANSETRON ondansetron 4mg/2ml amp box/5 indofarma 5,700
    4 ONDANSETRON ondansetron 8mg/2ml amp bo/5 indofarma 8,750

    ANTI SPASMODIK
    1 DOMPERIDON domperidon 10mg tablet box/100 52,100
    2 DOMPERIDON domperidon 5mg/5ml btl btl/60ml 15,900

    ANTI ALERGI & ANAFILAKSIS


    1 DEXAMETASON INJ DEXAMETASON 5MG/ML AMP box/100 80,114
    2 DEXAMETASON TAB DEXAMETASON 0,5MG TAB box/100 7,181
    3 CETIRIZINE CETIRIZINE 10MG TAB BOX/30 12,375
    4 EPINEFRIN EPINEFRIN 0,1%/ML AMP BOX/100 45,000

    PENENANG PRE OPERATIF


    1 DIAZEPAM INJ DIAZEPAM 5MG/ML @2ML AMP BOX/30 32,721
    2 DIAZEPAM TAB DIAZEPAM 5MG TAB BOX/1000 43,460
    3 ATROPIN ATROPIN 0,5MG TAB BTL/500 16,375
    4 ATROPIN ATROPIN 0,25MG/ML AMP BOX/30 13,970
    VITAMIN
    1 VIT K INJ VIT K 10MG/ML AMP BOX/30 36,663
    2 KALSIUM GLUCONAS KALSIUM GLUCONAS 100MG/ML AMP BOX/24 172,890
    3 VIT B COMP B COMP TAB BTL/1000 27,750
    4
    RAWAT INAP JAMKESDA TIPE C & D

    A TARIF RAWAT INAP


    PERAWATAN BIASA 75,000
    NICU / PICU 350,000
    HCU 150,000

    B PENUNJANG DIAGNOSTIK
    LABORATORIUM IIA 22,000 H2TL LED GOLONGAN DARAH PEMBEKUAN PERDARAHAN
    RADIOLOGI IIB 36,000 THORAX
    ELEKTROMEDIK IIC 30,000 CTG EKG
    60,000 USG KANDUNGAN
    LAB DILUAR PAKET
    GULA DARAH 9,000 GULA DARAH SEWAKTU

    FS HATI 11,000 BILIRUBIN TOTAL


    11,000 BILIRUBIN INDIREK/ DIREK
    11,000 SGPT
    11,000 SGOT

    FS GINJAL 11,000 UREUM


    20,000 CREATININ CLEARANCE
    20,000 UREUM CLEARANCE

    ANALISA LEMAK 11,000 CHOLESTEROL TOTAL


    11,000 CHOLESTEROL LDL
    11,000 CHOLESTEROL HDL
    15,000 TRIGLISERIDA

    SEROLOGI 20,000 ANTI HBs


    21,000 WIDAL

    URINE 5,000 PROTEIN KUANTITATIF

    HORMON 35,000 FREE T4


    35,000 TSH

    PA 55,000 BIOPSI JARINGAN SEDANG


    45,000 PAP SMEAR

    C TINDAKAN MEDIS
    PAKET TINDAKAN MEDIS 250,000 KURET TUBEKTOMI
    MEDIS OPERATIF I 1,100,000 EKSISI SIRKLASE LAPAROTOMI PERC
    MEDIS OPERATIF 2 1,500,000 KET HISTEREKTOMI PARSIAL KISTEKTOMI SC
    MEDIS OPERATIF 3 2,200,000 LAPAROTOMI TUMOR JINAK OVARIUM HISTEREKTOMI TOTAL

    D PELAYANAN PERSALINAN
    PER VAGINAM 500,000
    PER ABDOMINAL 1,500,000

    PELAYANAN DARAH / BAG 120,000


    KURET
    No. Nama Obat & Alkes Jml Satuan Harga PERAWATAN
    1 Gamex 8 1 11,000 11,000 1 klindamisin 300mg 10 950 9,500
    2 Katalar 0 300,000 120,000 2 as. Mefenamat 500mg 10 1,375 13,750
    3 Pospargin 1 7,000 7,000 3 B comp 3 30 90
    4 Spuit 3 cc 2 5,000 10,000 TOTAL 23,340
    5 Stesolid inj. 1 15,000 15,000
    6 Underpad 1 10,000 10,000
    7 Venflon no.20 1 18,000 18,000
    TOTAL 191,000

    SECTIO CAESARIA
    No. Nama Obat & Alkes JML Satuan Harga Perawatan
    1 Bisturi No.22 1 2000 2,000 1 klindamisin 300mg 20 950 19,000
    2 Blood set 1 23000 23,000 2 tramadol 15 445 6,675
    3 Cefriaxone inj. 2 15000 30,000 3 B comp 10 30 300
    4 Folly cathether 16 1 21000 21,000 Total 25,975
    5 Gamex 6 1 11000 11,000
    6 Gamex 6,5 1 11000 11,000
    7 Gamex 7 1 11000 11,000
    8 Gamex 8 1 11000 11,000
    9 Hifapix 25 cm 1 5900 5,900
    10 Induxin inj. 1 15000 15,000
    11 Masker 7 2000 14,000
    12 Needle 21 1 1000 1,000
    13 Needle No.27 1 1000 1,000
    14 Neo K 1 15000 15,000
    15 Pospargin inj. 1 7000 7,000
    16 Sensi gloves 8 1000 8,000
    17 Spuit 1 cc 1 5000 5,000
    18 Spuit 10 cc 1 5000 5,000
    19 Spuit 3 cc 1 5000 5,000
    20 Suction no.8 1 8000 8,000
    21 Supratule 1/2 lmbr 1 13000 13,000
    22 Topi 1 1200 1,200
    23 Umbilical 1 2000 2,000
    24 Underpad 1 10000 10,000
    25 Urine bag 1 7000 7,000
    26 Venflon 18 1 18000 18,000
    27 Kendil 1 2700 2,700
    Total 263,800

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